This topic is about the experiences and challenges faced by people with an ileostomy when it comes to passing kidney or gallstones. It explores the causes, prevention, and management of these stones, and seeks advice from the community. Here are some helpful insights and advice:

- Why stones form after an ileostomy:
- The absence of the colon leads to a continuous loss of water, sodium, potassium, bicarbonate, and calcium.
- The kidneys respond by producing low-volume, acidic urine, which can become supersaturated with calcium oxalate and uric acid, leading to kidney stones.
- In a straightforward ileostomy, the main concern is dehydration and electrolyte loss, rather than excess oxalate.

- Hydration and electrolyte replacement:
- It's important to drink a large amount of water, often 1 to 1.5 gallons (4 to 6 liters) per day.
- Use Oral Rehydration Solutions (ORS) instead of plain water to help the small bowel absorb fluids better. You can use the WHO "reduced osmolarity" ORS recipe or commercial packets.
- Some commercial high-sodium products mentioned include LMNT Recharge Electrolyte Hydration Powder and H2ORS Electrolyte Drink Powder.
- Typical sports drinks or hydration drops may not have enough sodium or potassium for those with an ileostomy.

- Medication options for kidney stones:
- Allopurinol may be prescribed to prevent uric-acid stones.
- Oral sodium bicarbonate can be used to raise urinary pH.
- Regular 24-hour urine studies, blood work, and renal ultrasounds are recommended. Bring your ileostomy surgical report to help tailor therapy.

- Medication options for gallstones:
- Some people may need a cholecystectomy, while others manage pain with Bentyl (dicyclomine) and analgesics if further surgery is not possible due to adhesions.

- Simple dietary and home measures:
- Drinking a glass of lemon juice daily has been reported to help stop recurrent stones.
- Apple-cider vinegar has been tried by some, with mixed results.
- A low-oxalate diet is suggested, although stones are mainly related to dehydration.
- Plant-based, low-purine diets alone did not prevent uric-acid stones for at least one person.

- Managing an acute stone:
- Many people pass small, sand-like stones daily without pain if they stay well hydrated.
- Larger stones may require laser lithotripsy and temporary ureteral stenting, which can be painful and limit activity.
- Strain urine to collect stones for analysis of size and composition.

- Clinical follow-up advice:
- If stones are frequent or occur daily, seek a second opinion, preferably at a teaching or university hospital, to ensure management is tailored to the specific needs of someone with an ileostomy.

- Miscellaneous tips:
- ORS recipes and additional information are available from WHO publications and various medical websites.
- Keep copies of operative reports, as the length of the ileum used for the stoma can help specialists determine remaining absorptive capacity.